Physiotherapy and hydrotherapy for osteoporosis

Physiotherapists can help people with osteoporosis to reduce pain and improve mobility, improve posture and prevent falling and fractures. People generally receive physiotherapy after spinal, hip and wrist fractures and some people we talked with had physiotherapy after spinal surgery to help them recover strength and movement. Physiotherapy can be provided as an inpatient and outpatient. Hydrotherapy (gentle exercise in warm water), was received by several of those we interviewed with spinal fractures to help relax their muscles.
Physiotherapists were often described as ‘good’, ‘helpful’ and ‘encouraging’. Several of the people we talked to required regular physiotherapy sessions to help them cope with pain or immobility provoked by osteoporosis and/or other conditions such as arthritis or hemiplegia.

Robert learnt that some of the pain he was experiencing was the result of bad posture and being…

Age at interview 49

Gender Male

Age at diagnosis 43

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After their allocated physiotherapy sessions are over, people are expected to continue at home with the exercise routine learnt at hospital.

Iris had physiotherapy for 12 weeks and then she continued on a daily basis with the routine set…

Age at interview 60

Gender Female

Age at diagnosis 59

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But not everyone who was sent home with a booklet of exercises managed to do them regularly. The one to one interaction with the physiotherapist was an important motivating and reassuring factor, especially for people who experienced pain on an ongoing basis. Sarah said that she is ‘lazy’ but when she does her exercises she still experiences pain. Many people explained that after a fracture they lost confidence and were fearful of falling and breaking another bone or doing a bad movement and going into spasm (see also Feelings and thoughts about osteoporosis).

It was very painful when Dennis first had physiotherapy after his fracture but now he has no pain…

Age at interview 59

Gender Male

Age at diagnosis 55

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A few people we talked to paid to see a private physiotherapist. People’s experience of private physiotherapy varied. Jane said that during her pregnancy before she was diagnosed she spent ‘an absolute fortune’ on private sessions because she couldn’t understand why she was having so much backache.

Elizabeth was disappointed with the private physiotherapist she saw.

Age at interview 85

Gender Female

Age at diagnosis 66

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Jenny paid for private physiotherapy, which she says has been very helpful.

Age at interview 62

Gender Female

Age at diagnosis 55

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A few people thought that physiotherapy should be a long-term rather than a short-term treatment. They argued that in some cases help may be needed not just to help people to deal with the after effects of a fracture but to restore confidence as well.

After her spinal fractures Jane was allocated six twenty minute sessions of physiotherapy which…

Age at interview 42

Gender Female

Age at diagnosis 36

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There may be times when someone with osteoporosis is advised not to have physiotherapy due to the fragility of the osteoporotic area or severity of pain, so it is always a good idea to tell your GP that you are having private physiotherapy or any other treatment such as osteopathy. The best person to seek advice from is the GP or the physiotherapist. But an individual’s knowledge of his/her own body should also help to make that decision. Several people were referred by their GP to see a physiotherapist that specialised in spinal injuries.
In several cases very gentle and minimal exercises were recommended. Heavy manual work can sometimes be seen as replacing the need for physiotherapy but it can also aggravate the level of pain experienced by the person.

Noreens physiotherapist gave her gentle massage and gentle exercises to do because her back was…

Age at interview 77

Gender Female

Age at diagnosis 75

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Laurence would like advice from his GP about whether to have physiotherapy and how much exercise…

Age at interview 62

Gender Male

Age at diagnosis 54

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David had plenty of physiotherapy as a child but he chooses not to have any now because he…

Age at interview 25

Gender Male

Age at diagnosis 23

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Sarah describes her last physiotherapy as a more vigorous and painful session and she is unsure if it is the physiotherapy or the length of time that has passed since her fracture that have improved her symptoms.

Sarah enjoyed hydrotherapy. After her last physiotherapy session the back of her hand has been numb.

Age at interview 61

Gender Female

Age at diagnosis 61

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Having to travel to have physiotherapy or to go to a rehabilitation centre is not always easy particularly if you are disabled and/or unable to take public transport. Several of the people we talked to commented on how uncomfortable it was for them to travel on public transport. Jane said that being in pain during the journey to the hospital diminished the benefits of physiotherapy. Several would find it useful to have facilities nearer to home which they could walk to (see summary Osteoporosis, mobility, driving and transport).

Christines physiotherapist has been most willing to help and to look for alternative…

Age at interview 68

Gender Female

Age at diagnosis 61

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Elderly patients are sometimes confused or forget relevant information regarding their treatment. Beryl is seventy-two years old and has restricted neck movement and following an x-ray her GP decided she would benefit from physiotherapy. But she forgot about the x-ray and therefore her session was postponed until the physiotherapist was able to confirm this information.

Beryl forgot she had had an x-ray and her physiotherapy session was postponed.

Age at interview 72

Gender Female

Age at diagnosis 69

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Exercise classes by physiotherapists

One thing that some of those we talked to would welcome is exercise classes designed/guided by physiotherapists. Some people would like more information and guidance regarding weight bearing exercises or any other type of exercise that is good for osteoporotic bones. Several said that ordinary gyms do not have the proper expertise to help them and so they are wary of doing weight bearing exercises in case they fracture (see also Osteoporosis and exercise).

Irene took part in a twelve week exercise programme specially designed by a physiotherapist for people with osteoporosis. The programmes aim was to measure the benefits of exercise for people with the condition. Her local hospital continues running this programme. According to Irene the exercise programme for people with the condition has expanded beyond the hospital premises as leisure centres in the city also became interested in implementing such a programme. Sports staff are trained by hospital physiotherapists.

Irene explains how the exercise programme for people with osteoporosis came about and how it has…

Age at interview 68

Gender Female

Age at diagnosis 49

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Irene said that the exercise programme was like a drug trial study. The physiotherapist…

Age at interview 68

Gender Female

Age at diagnosis 49

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Irene talks about the type of movements included in the exercise programme for people with…

Age at interview 68

Gender Female

Age at diagnosis 49

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Hydrotherapy

A few of those we interviewed had hydrotherapy sessions. Some had it when they were staying in hospital. Cressida, who over the years had many spells in hospital, said that physiotherapy and hydrotherapy was offered ‘automatically’. One support group organised its own sessions and regularly hired the pool at the local hospital under the supervision of a physiotherapist. Several people said that the experience of weightlessness allowed them to be pain-free and they found it very relaxing. Many people also see swimming as a good alternative and either swim lengths or do gentle exercises (see also Osteoporosis and exercise).

Rose went to weekly hydrotherapy classes where she was able to do exercises in the water which…

Age at interview 76

Gender Female

Age at diagnosis 57

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Physical activities and ‘weight bearing exercises’ such as walking, jogging, climbing stairs and push-ups, which improve bone strength are beneficial for people with osteoporosis.

Medication for osteoporosis

The current medicines licensed for osteoporosis aim to prevent further bone loss and to reduce the risk of fractures. Osteoporosis is classified as a 'chronic...

Surgery for osteoporosis

Many of those we talked to have had fractures before and after their diagnosis of osteoporosis and several have had surgery to help decrease the...